Provider Demographics
NPI:1457642191
Name:AKIONA, LYNN CHERYL (D044773)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:CHERYL
Last Name:AKIONA
Suffix:
Gender:F
Credentials:D044773
Other - Prefix:DR
Other - First Name:LYNN
Other - Middle Name:CHERYL
Other - Last Name:AKIONA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:D044773
Mailing Address - Street 1:359 W MADISON AVE
Mailing Address - Street 2:STE200
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-3455
Mailing Address - Country:US
Mailing Address - Phone:619-440-6365
Mailing Address - Fax:619-440-7629
Practice Address - Street 1:3639 MIDWAY DR
Practice Address - Street 2:STE. B-136
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-5254
Practice Address - Country:US
Practice Address - Phone:619-244-0880
Practice Address - Fax:619-440-7629
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-28
Last Update Date:2012-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA044773122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist